Cystic Liver Metastasis from Oropharyngeal Squamous Cell Carcinoma Mimicking A Benign Hepatic Cystic Lesion

Hepatic cysts are common benign incidental findings, whereas cystic liver metastases are rare findings. We report a case of p16-positive oropharyngeal squamous cell carcinoma in which a hepatic lesion initially presumed to be a benign hepatic cystic lesion was subsequently identified to be cystic metastasis. During surveillance after chemoradiotherapy, the lesion demonstrated progressive enlargement, increasing internal heterogeneity, and subsequent wall thickening, raising suspicion of malignancy. Surgical resection confirmed the diagnosis of metastatic squamous cell carcinoma. This case underscores that cystic liver metastasis may mimic a benign hepatic cystic lesion and thus requires careful longitudinal imaging assessment.